静脉支架的理想特性是什么?

I. Massi, P. Zamboni
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引用次数: 2

摘要

历史上,用于静脉系统的支架不是专用支架。它们很大程度上是动脉支架。静脉支架的一个基本特征是顺应性,以便使其横截面积适应静脉。它还应该耐压、耐腐蚀和耐疲劳。该材料应不透光,以便随访。理想的静脉支架的另一个特点是灵活性,使其形状适应静脉,而不是相反。支架也要揭开,以免络闭塞。理想的静脉支架不应移位,因此需要大直径、长长度的支架。径向力对防止偏移很重要。然而,目前由动脉使用的支架显示高径向力,这可能影响薄静脉壁的通畅。或者,如果支架有一个锚点,允许被动锚定,避免迁移所需的径向力将更低。专用静脉支架直到最近才出现。此外,还有一项关于新型顺应性镍钛合金支架的临床前研究,命名为Petalo CVS。除了大静脉阻塞最常见的原因外,专用静脉支架还可以治疗最近描述的其他疾病,如Eagle综合征的颈静脉变异型、JEDI综合征和慢性脑脊髓静脉功能不全的颈静脉病变,这些疾病根据Giaquinta分类不利于血管成形术。
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What are the ideal characteristics of a venous stent?
Historically, the stents used in the venous system were not dedicated scaffolds. They were largely adapted arterial stents. An essential feature of a venous stent is compliance, in order to adapt its crosssectional area to the vein. It should also be crush resistant, corrosion resistant and fatigue resistant. The material should be radiopaque, for follow-up. Another characteristic of the ideal venous stent is flexibility, to adapt its shape to the vein, not vice versa. The scaffold should be uncovered too, in order to avoid the occlusion of collaterals. The ideal venous stent should not migrate, so it is necessary a large diameter and a long length. The radial force is important to prevent migration. However, current stents derived from arterial use display high radial force, which could affect the patency of the thin venous wall. Alternatively, if the stent has an anchor point, that permits a passive anchoring, the radial force required to avoid migration will be lower. Dedicated venous stents were not available until very recently. Furthermore, there is a preclinical study about a new compliant nitinol stent, denominated Petalo CVS. Out of the commonest causes of large veins obstruction, dedicated venous stent could also treat other diseases described more recently, such as the jugular variant of the Eagle syndrome, JEDI syndrome and jugular lesions of the chronic cerebrospinal venous insufficiency that result unfavorable for angioplasty according to Giaquinta classification.
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